Benchmarks in

Value-Based Healthcare

Brought to you by the

Healthcare Intelligence Network

www.hin.com

- Introduction

- New Players on the Value-Based Healthcare Team

- Patient-Centered Strategies to Generate Value-Based Reimbursement

- Reducing Readmissions for Value-Based Healthcare

- Sources

- For More Information

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Value-Based Healthcare

Introduction

- Healthcare reform is moving toward value-based reimbursement, which has created a mashup of care delivery and reimbursement models and a need to recruit new talent.

- But, with time and resources at a premium, healthcare organizations are increasingly selective about allocation of human and financial capital.

- One key to approaching value-based reimbursement is to reduce rehospitalizations and avoid CMS penalties for unsatisfactory readmission rates of Medicare patients.

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New Players on the

Value-Based Healthcare Team

- 75% of organizations offer some form of health coaching. (HIN’s 2013 Health

Coaching Survey)

- Job postings for care transitions coordinators increased 40% from 2011 to 2012. (HIN’s 2013 Care Transitions Survey)

Who is on the team?

1. Patient navigator 2. Health coach 3. Hospitalist

4. Director of patient experience 5. Care transitions coordinator 6. Physician champion

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Patient-Centered Strategies

To Generate Value-Based

Reimbursement

- The areas best suited to generating value-based reimbursement are:

1. Population health management (56%) 2. Care coordination (50%) 3. Integrated care delivery (42%) 4. E-health and telehealth (39%)

- Patient experience is increasingly becoming a top priority for organizations.

5. Access to care (33%) 6. Health and wellness (26%) 7. Dual eligibles (25%)

(HIN’s 2014 Healthcare Trends and Forecasts survey)

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Patient-Centered Strategies

To Generate Value-Based

Reimbursement

- Access to care: 87% say home visits increased patient-satisfaction, and 69% say home visits decreased ER visits and hospital readmissions. ( HIN’s 10 Questions on

Home Visits in 2013 Survey)

- Weight/physical activity is a patient health coaching priority for 81%. (HIN’s Health

Coaching in 2013 survey)

- 81% say dual care management programs feature patient education. (HIN’s 10

Questions on Dually Eligible in 2013 Survey)

- Up to 90% of readmissions by Medicare beneficiaries are unplanned and unnecessary. (NEJM, 2009)

- 11% of readmissions are due to medication non-adherence, at a cost of nearly $100 billion annually. (CMS, 2012)

- In 2015, the number of conditions subject to CMS penalties will reach eight.

(CMS 2012)

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Reducing Readmissions for

Value-Based Care

Why is it vital to reduce readmissions?

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Reducing Readmissions for

Value-Based Care

What are the Top 5 Ways to Reduce Readmissions? 1. Discharge Plans 2. Disease Management 3. Medication Reconciliation 4. Care Transitions Management 5. Education

Who are the Targeted Populations? 1. Cardiovascular Disease 2. Pneumonia 3. Stroke 4. Frail Elderly

(HIN’s 2012 Readmissions Survey)

Sources

- Reducing Readmissions for Value-Based Healthcare Infographic

http://www.hin.com/infographics/Reducing_Readmissions.html

- New Players on the Value-Based Healthcare Team Infographic

http://www.hin.com/infographics/Valuebasedhealthcareteam.html

- 7 Patient-Centered Strategies to Generate Value-Based Reimbursement Infographic http://hin.com/infographics/7_ValueBased_Healthcare_Priorities.html

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For More Information

- Visit www.hin.com

- Call (888) 446-3530

- Follow @H_I_N on Twitter

- Like us on Facebook: www.facebook.com/TheHealthcareIntelligenceNetwork

- Connect with us on LinkedIn:

www.linkedin.com/company/healthcare-intelligence-network

- See Driving Value-Based Reimbursement with Integrated Care Models, available at store.hin.com

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